The First Experience with Sodium-Glucose Cotransporter 2 Inhibitor for the Treatment of Systemic Right Ventricular Failure

Figures

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  Figure 1. (A) Postero‐anterior, (B) lateral chest X‐ray, and (C) computed tomography image of the patient with congenitally corrected transposition of the great arteries anatomy with posterior position of the dilated systemic right ventricle (red) with mechanical tricuspid valve (yellow), prominent trabeculation, hypertrophic moderator band (green arrow), and pacing lead in coronary sinus (red arrow) and anterior position of the right atrium with atrial lead (black arrow) and subpulmonary left ventricle (blue) with transvenous pacing and implantable cardioverter‐defibrillator leads in situ (blue arrow).

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  Figure 2. Twelve‐lead electrocardiogram of (A) sinus rhythm with a high degree atrioventricular block with ventricular rate 38/min and (B) sinus rhythm 69/min with sequential subpulmonary left ventricular pacing. Note the broad paced QRS complex of 180 ms, (C) sinus rhythm 60/min with biventricular pacing. Note the change in QRS complex morphology illustrative of the electrical contribution of the systemic right ventricular activation.

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  Figure 3. Graphic depiction of the anatomy of the patient with congenitally corrected transposition of the great arteries, illustrating the dilated systemic right ventricle with hypertrophic moderator band and infarcted area, the mechanical tricuspid valve, and the transvenous cardiac resynchronization therapy‐defibrillator in situ.

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  Figure 4. A schematic timeline of the patient's clinical course. AV, atrioventricular; ccTGA, congenitally corrected transposition of the great arteries; CRT‐D, cardiac resynchronization therapy‐defibrillator; CRT‐P, cardiac resynchronization therapy‐pacemaker; SGLT‐2, sodium‐glucose cotransporter 2; sRV, systemic right ventricular; TVR, tricuspid valve replacement.